宫颈扩张球囊与地诺前列酮栓在足月妊娠产妇引产促宫颈成熟中的效果对比

Comparison of the effect of dilated cervical balloon and denoprostol suppository in inducing labor and promoting cervical maturity in full-term pregnant women

目的探讨足月妊娠产妇引产应用宫颈扩张球囊与地诺前列酮栓促宫颈成熟的临床效果。方法选取150例引产的足月妊娠产妇,按照治疗方法不同分为球囊组与药物组,每组75例。球囊组采用宫颈扩张球囊引产,药物组采用地诺前列酮栓引产。对比两组临床效果。结果引产前,两组宫颈Bishop评分对比,差异无统计学意义(P>0.05);引产后,两组宫颈Bishop评分明显高于引产前,差异具有统计学意义(P<0.05),两组引产后宫颈Bishop评分、促宫颈成熟有效率对比,差异无统计学意义(P>0.05),药物组缩宫素使用率显著低于球囊组,差异有统计学意义(P<0.05)。药物组临产时间(8.44±0.72)h、总产程时间(6.33±2.71)h均显著短于球囊组的(12.29±0.87)h、(8.58±2.82)h,阴道分娩率66.67%低于球囊组的82.67%,中转剖宫产率33.33%高于球囊组的17.33%,差异有统计学意义(P<0.05)。药物组人工破膜率、绒毛膜羊膜炎发生率低于球囊组,胎儿窘迫发生率高于球囊组(P<0.05)。结论宫颈扩张球囊与地诺前列酮栓均具有良好促宫颈成熟引产效果,其中地诺前列酮栓起效快,产程时间短,但该法可能导致产妇出现强直宫缩,导致胎儿窘迫,中转剖宫产率偏高。宫颈扩张球囊引产作用温和,利于促进阴道分娩,但存在发生绒毛膜羊膜炎风险,容易增加母婴感染。

Objective To investigate the clinical effect of cervical dilation balloon and denoprostol suppository on promoting cervical maturity in term pregnancy induced labor.Methods 150 cases of induced full term pregnant women were selected and divided into balloon group and drug group according to diff erent treatment methods,75 cases in each group.The balloon group was induced by dilating cervical balloon,and the drug group was induced by denoprostol suppository.The clinical effects of the two groups were compared.Results Before labor induction,there was no significant diff erence in Bishop score between the two groups(P>0.05).After labor induction,the cervical Bishop score of the two groups was significantly higher than that before labor induction,and the diff erence was statistically significant(P<0.05).There was no statistical diff erence in the cervical Bishop score and the effective rate of promoting cervical maturity between the two groups after labor induction(P>0.05).The utilization rate of oxytocin in the drug group was significantly lower than that in the balloon group,and the diff erence was statistically significant(P<0.05).The delivery time(8.44±0.72)h and total labor time(6.33±2.71)h in the drug group were significantly shorter than those in the balloon group(12.29±0.87)and(8.58±2.82)h.The vaginal delivery rate was 66.67%lower than that in the balloon group(82.67%),and the caesarean delivery rate was 33.33%higher than that in the balloon group(17.33%).The diff erence was statistically significant(P<0.05).The incidence of artificial rupture of membrane and chorioamnitis in drug group was lower than that in balloon group,and the incidence of fetal distress was higher than that in balloon group(P<0.05).Conclusion Both cervical dilation balloon and dinoprostone suppository have good effects on promoting cervical ripening and induction of labor.Among them,dinoprostone suppository has fast onset and short labor time,but this method may lead to tonic contractions in pregnant women and lead to fetal distress.,the transfer rate of cesarean section is high.Cervical dilation balloon has a mild effect on labor induction and is conducive to promoting vaginal delivery,but there is a risk of chorioamnionitis,which may increase maternal and infant infection.